Keratosis Pilaris – Consultant Treatment for Bumpy or Rough Skin in London

What is keratosis pilaris?

Keratosis pilaris (KP), sometimes called follicular keratosis, is one of the most common dermatological conditions worldwide. It is characterised by small, rough, goose-bump-like spots that appear when keratin – a protein in skin and hair – accumulates and plugs hair follicles. While harmless, it often causes cosmetic concern. KP is frequently referred to as “chicken skin” because of its distinctive texture.

Causes and how it develops

The exact cause of keratosis pilaris is not fully understood, but it is linked to abnormal keratinisation, where keratin builds up and blocks the follicular opening. This leads to tiny plugs that form rough bumps. Genetic predisposition plays a major role, as KP often runs in families. It is more common in individuals with dry skin, eczema (atopic dermatitis), asthma, or ichthyosis vulgaris.

Environmental factors also influence severity. KP tends to worsen in winter months when the air is dry and improve during summer with increased humidity and sun exposure. Hormonal shifts during puberty and pregnancy may also make it more noticeable.

Symptoms and patterns

Keratosis pilaris symptoms include:

• Small, rough, flesh-coloured, red, or brown bumps that feel like sandpaper.
• Most commonly appear on the upper arms, thighs, buttocks, and cheeks.
• May be associated with mild redness, dryness, or itching.
• Skin texture often described as resembling “permanent goose bumps.”
• Symptoms can fluctuate seasonally, worsening in dry weather.

In children, the cheeks are commonly affected, whereas in adults the arms and thighs are more typical. Though KP is usually symmetrical, it can sometimes be patchy.

Diagnosis and tests

Diagnosis is clinical and based on skin appearance and history. A dermatologist examines the typical distribution of follicular papules. No laboratory tests are usually needed, but assessment may rule out conditions with similar features, such as folliculitis, acne, or pityriasis rubra pilaris.

Treatment options and management

Keratosis pilaris has no permanent cure, but treatments focus on improving appearance and skin feel. Management is usually long-term, as symptoms often return when treatment stops.

Topical treatments

First-line care includes emollients with exfoliating agents to soften plugs and smooth skin:

• Urea creams (10–20%) – hydrate skin and dissolve keratin plugs.
• Lactic acid lotions – gently exfoliate and improve skin texture.
• Salicylic acid – helps unblock pores and reduce redness.
• Topical retinoids (tretinoin, adapalene) – regulate keratinisation and promote turnover.

Procedural treatments

When topical care is insufficient, dermatology-led interventions may help:

• Laser therapy – vascular lasers (e.g., pulsed dye) reduce redness; fractional lasers may smooth texture.
• Microdermabrasion or chemical peels – gently resurface and improve roughness.

Lifestyle and self-care

Patients are encouraged to adopt supportive routines:

• Daily use of non-soap cleansers and moisturisers.
• Avoid harsh scrubbing, which worsens irritation.
• Humidifiers in winter to prevent dryness.
• Sun protection to prevent pigmentation changes.

Complications and quality of life impact

Keratosis pilaris is benign but may affect confidence and self-esteem, particularly in adolescents and young adults. Scratching or aggressive exfoliation can cause hyperpigmentation, scarring, or secondary infection. Emotional distress is common, and treatment often focuses on improving cosmetic appearance and wellbeing.

Prognosis

KP usually improves with age and may disappear entirely by adulthood, though some people continue to have mild symptoms lifelong. With consistent care, most patients achieve smoother, clearer skin and significant reduction in redness.

Why choose Skinhorizon for keratosis pilaris?

• Consultant dermatologist-led assessment with accurate diagnosis and exclusion of mimicking conditions.
• Tailored plans including prescription creams, procedures, and medical-grade skincare.
• Access to advanced laser treatments for redness and texture.
• Personalised support to improve skin comfort, confidence, and long-term control.

Your first visit — what to expect

1. History: Review of skin symptoms, family history, atopic conditions, and treatment attempts.
2. Examination: Inspection of affected sites and ruling out other follicular disorders.
3. Discussion: Education about KP, natural course, and realistic treatment outcomes.
4. Treatment plan: Personalised mix of medical creams, supportive skincare, and optional procedures.
5. Follow-up: Review results, adjust regimen, and provide ongoing care strategies.

Reviewed by: Dr Mohammad Ghazavi, Consultant Dermatologist
Skinhorizon Clinic, 4 Clarendon Terrace, Maida Vale, London W9 1BZ
Last reviewed: 21 August 2025